A new tool for measuring client experience Catherine Joyce Research & Innovation Manager Anglicare Australia Conference September 2017

Background

What is ‘client experience’? Client satisfaction How satisfied are you with information about your care? Associated with expectations – high satisfaction is common Low satisfaction is hard to interpret or act on without further information Client experience Have you been provided with information about your care? Did staff check that you understood the information? Associated with quality of care Direct link to actions of provider to improve care and services Client outcomes Has this service assisted you to do the things that are important to you? Impact of services/care - quality of life measures Can be hard to link to different aspects of service/ care (what made the impact)?

Developing a tool Clarify purpose Review existing tools and approaches Develop conceptual framework (domains of interest) Adopt/adapt/design data collection tool Don’t just develop a tool: Develop detailed procedures for all stages of the project

Purpose of Benetas Experience Survey Goal: to better understand the experiences of clients accessing Benetas services in order to identify areas of service provision that can be improved or changed. Objectives: Provide an opportunity for service users to provide feedback that informs quality improvement Identify the extent to which Benetas’ principles and values are reflected in service user experiences Generate evidence to contribute to monitoring of Quality Management Framework, as well as external accreditation or other standards.

Elements of existing tools can be used. Review of tools: key findings No “gold standard” Often aligned with ‘satisfaction’ rather than experience’ approach Often not tested or validated in Australian aged care settings Feasibility & practicality (time, cost etc.) No single best fit with Benetas QMF and AACQA principles Elements of existing tools can be used.

Survey Tool: Domains Domain Description Dignity, autonomy & choice Respect for inherent personhood Autonomy, independence, individuality and choice Staff interactions Relationships with staff Information and communication Personal & clinical care Personal care: help with dressing, eating, bathing, going to the toilet Clinical care: nursing care, pain management, medication management, palliative care etc. Lifestyle & support services Lifestyle: Access to meaningful and enjoyable activities, social interaction, physical activity/mobility Support services: Meals, cleaning Service environment [Residential facilities only] Physical environment, atmosphere, sense of safety

Survey Tool: Domains Domain AACQA draft single quality standards AACQA literature review Benetas QMF Objectives Benetas Values Dignity, autonomy and choice Consumer dignity, autonomy and choice Feedback and complaints Respect and dignity Choice Organisational environment & resources 1: Responsive to and respectful of the individual person and focused on their choices and needs. Respect: We take the time to understand and value each person and respect their choices. Staff interactions Human resources Staff actions and interactions Spirit: We build a positive, energetic culture dedicated to creating fulfilling life experiences for older people. Community: We strive to build strong relationships and communities of interest among all stakeholders by working together in an open, involving way Personal and clinical care   Ongoing assessment and planning with consumers Delivering personal care and clinical care Clinical and personal care 2: Supportive of each person to fulfil their quality of health and quality of life. potential to live their best life 3: Safe and free from preventable harm. Respect Responsibility: We act with integrity towards our clients, their families and carers, our supporters and the broader Anglican community. Lifestyle and support services Delivering lifestyle services and supports Social environment 2: Supportive of each person to fulfil their quality of health and quality of life potential to live their best life. Spirit Service environment Physical environment Functional environment Responsibility Not included Organisational governance

Survey tool content Domain Survey section name Overall Dignity, autonomy & choice My rights and choices Lifestyle & support services My interests Staff interactions Benetas staff Personal & clinical care My care [and services] Service environment My environment

Producing the final version Question design Response formats Plain language Layout

But wait, there’s more…

Survey approach Engagement Promotion Sample preparation Planning Engagement Promotion Sample preparation Data collection Resource requirements Modes of collection Data management Reporting Key audiences Actionable information

Engagement Early consultation meetings with key end-users and other key stakeholders Iterative review of draft materials and procedures Communication Plan: Information to operational staff through multiple channels

Promotion Promotional materials developed Flyers mailed to >1000 home care clients Posters, FAQs and flyers distributed to 13 residential facilities and 3 respite centres FAQs distributed to operational staff

Sample preparation Survey sample Home care client list – generate and review Residential client list – generate and review Resident relatives list – generate and check Respite clients & relatives list – generate and check Home care relatives list – generate and check Sample preparation

Data collection methods   Promotion Recruitment method Data collection methods In person - assisted Phone - assisted Hard copy Online Home care clients Mailout flyer RAs by phone  Respite clients Posters, flyers, & FAQs at sites RAs onsite, as directed by staff Residential clients Posters, flyers & FAQs at sites Family members (all) (indirect) Mailout

Survey approach: key considerations Data collection by research team, not usual care staff Ability to report results by at a meaningful unit of analysis Separate processes for care recipients versus families Clear dissemination and reporting plan (“closing the loop”) which takes account of local context

Conclusion Purpose drives everything There’s no need to re-invent the wheel, but make sure it’s relevant to your context Engagement is key Creative problem-solving and flexibility is a must